Contextual Influences In Nursing

De Casterlé, Bernadette Dierckx, Sabine Goethals, and Chris Gastmans. "Contextual Influences on Nurses’ Decision-Making in Cases of Physical Restraint." Nursing Ethics 22.6 2015: 642-651. Academic Search Premier. ProQuest Ebrary. Web. 19 Oct. 2015. http://proxy1.aims.edu:2069/ehost/detail/detail?sid=6a63fd4c-8166-41b7-ab7d-4c4812b4dc96%40sessionmgr4001&vid=10&hid=4114&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=109264802&db=aph This journal is about “Contextual influences on Nurses Decision-Making in Cases of Physical Restraint” written by De Casterle, Dierckx, and Goethals. This article covers the thought process behind medical ethics of nurses who make the call about if a physical restraint should be used. The design to breaking down the thought

This project started back in 1994 and according to the author has been an ongoing never ending project filled with staff education and teamwork. The results of this project was a dramatic reduction in the use of physical restraint and an overall feeling of improvement for the quality of life among patients. This article breaks down the methods used in order to achieve the goals sit for this hospital. This hospital is the largest in Virginia housing 250 patients at the start of this project, according to the author “44% of the total patient population were in restraints.” The first step was to gather a committee who brain stormed how to make their goals possible for their facility. Once making plans to go “restraint-appropriate versus restraint-free” patients were reevaluated by the entire team looking for alternatives to risk rather than resting on a restraint as an option. Moving forward with their goals they offered large amounts of staff re-education on restraints. This article talks about the setbacks of failed attempts at alternatives, showing that the staff in the hospital had a trial and error growing process. When patient injuries happened the staff assured everyone that they were in this together as a team. This article shows the overuse of restraints and the positive attitude to correct that overuse. This article will be part of my argument in the sense

This was a survey done asking the patients families what their thoughts on medical restraints was. This was done in the form of convenience sample of 25 families, having them fill out a questionnaire with set questions. According the authors Lai and Wong, 84 % of the people who filled out the questionnaire had no comment to their family members being restrained. “Three of them (12%) said that they actually preferred its use.” Out of the 25 families sampled only one family disliked the use of a physical restraint due to lack of comfort for the patient. Another questions asked on the survey was if the families exercised the choice to remove the restraint during their visits, according to Lai and Wong “only two of them (8%) said that they would.” The most common finding of this survey though was the fact most of the families were unaware of there being alternatives to the restraints (52%). Another common thing found among this report is only about half of the families were informed that restraints would be applied before the action was taken. One of the many reasons this article was picked is because it shows a study of the thought process of the family rather than the staff. The fact that the sample was picked poorly makes me worried to use this in the argument but the evidence is strong that some of the family also supported the use of